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General NPI Number Information
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NPI Number | 1992815104
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Entity Type | Organization
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Legal Business Name | BARRETT SPINAL CARE P C
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 441 S MUSKOGEE AVE
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City | TAHLEQUAH
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State | OK
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Zip | 74464-4427
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Country | US
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Telephone | 918-453-0112
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1778
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City | TAHLEQUAH
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State | OK
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Zip | 74465-1778
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Country | US
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Telephone | 918-453-0112
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RYAN THOMAS BARRETT
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Credential | D.C.
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Telephone | 918-453-0112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 3664
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License Number State | OK
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